TWIN RIVERS UNIFIED SCHOOL DISTRICT
Application to Receive the State Seal of Biliteracy (SSB)
Upon Graduation
SPRING 2015
Due: Friday, March 6, 2015
Check School: ____ FHS ____ GHS ____ HHS ____ RLHS ____ CCAA ____ Alternative ED
I wish to receive the Seal of Biliteracy on my high school diploma and an annotation of my bilingual skills on my transcript. I have met
the following eligibility requirements:
_______
Successful completion of all high school graduation requirements including successful completion of all English
requirements, with a minimum overall GPA of 2.0. (Counselor will attach copy of current transcript, dated Feb 27,
2015 or later.)
_______
Pass CAHSEE Exam*
AND ONE of the following (please attach verification to this application):
1. _______
2. _______
3. _______
4. _______
5. _______
6. _______
A score of “3” or better as a junior on the AP (Advanced Placement) exam for a world language.
(Copy of grade report or current transcript, dated Feb 27, 2015 or later.)
Successful completion of the District approved four-year course of study in the same world
language, with a 3.0 or higher GPA in these courses.
Successful completion of the District approved two-year course of study in the Native Speakers
course with a 3.0 or higher GPA. (Copy of current transcript, dated Feb 27, 2015 or later.)
Pass a foreign government’s approved language examination and receive a certificate of
competency for that language from authorizing government agency.
Pass the Scholastic Assessment Test (SAT) II foreign language examination with a score of 600 or higher.
Pass a district approved exam.
If the primary language of a pupil is other than English, he or she shall do both of the following in order to qualify for the SSB:
CELDT level: ______ (Attain the Early Advanced proficiency level on the California English Language Development Test (CELDT). For
the purpose of determining SSB eligibility, a participating school district may administer the CELDT test an additional time as
necessary)
Student’s Name: ____________________________ Language: __________________________
(PLEASE PRINT)
Counselor’s Name:
_________________
(SEPARATE APPLICATION FOR EACH LANGUAGE)
Student I.D.:
____________________ ♀Female __ or ♂Male __
Please return this application and all verification documents to the Seal of Biliteracy to your counselor at your site by March 6, 2015.
Counselor’s use only 
_____ Verified proficiency in English on CST (junior year), a minimum overall GPA of 2.0, and one of the above world language requirements.
Approved for Seal of Biliteracy Award.
_____
Not Approved due to the following:
Counselor's Signature _________________________________ Date: _____________
Please return all completed applications to Graciela García-Torres, EL/ELD Director at Bay C by Friday, March 13. 2015.
Date Received: ___________________District Program Director’s Signature: ___________________________ Date:________________